Any shortcut we can take which allows us to pick up the essentials of cognitive behavioural therapy may be worthwhile, argues Michael O'Sullivan.

One of the best shortcuts around involves learning the acronym STAIRCASE, from Marvin Goldfried. It starts with the letter ‘S’, of course. Here’s the first principle…

S - this is the situation we happen to be in at any time. Describing a “situation” is not easy since we are always in one kind of “situation” or another. It helps to begin to think of our lives as slices of time with a beginning, middle and end. The start of a problem situation will be whenever things appear to turn “sour”- Think about when this happens, whom we are with, how long it goes on for and how it turns out.

T - these are our thoughts about the situation. In recording thoughts it helps to write them down as close to the situation as possible. If we try to think about our “thoughts” one week after the event, time will contaminate them and they will be less fresh or vivid.

A - This is the affect, which is emotion. What emotions are we feeling, which one is the strongest?

I - this is intention. What do we want from this situation? What is the outcome we are looking for?

R – This is response. How do we respond to the situation?

C – This is the is consequence. What is the actual outcome?

ASE  stands for “and situation evaluation”… How do we evaluate the consequences of our actions.

Attention to detail

If we are to use STAIRCASE, then the devil will be in the detail. Our thoughts can be directly related to what is “happening” in the situation. They can be thoughts about how far the situation is resembling past events or they can be appraisals about ourselves. These latter two types are problematic, as they are not grounded in the situation we happen to be in at that time. They are thoughts which disconnect us from the environment. We may want to revise these thoughts.

Our intention may be the outcome we desire but how helpful is this? Tony wanted his girlfriend to behave “differently” towards him. This was understandable but is not achievable, as the actions of others is outside of our control. An “intention” needs to be achievable and should be compatible with our response. Tony’s new intention was to communicate how upset he was to his girlfriend but he responded by withdrawing into himself. When he responded “assertively” his actions matched his intention. In an ideal world the consequence (the actual outcome) should reflect our intention (the outcome we wanted) and our response.

If there is a large gap between intentions and consequences, we will know then in our “situation evaluation” which should then prompt us to do something different. People with depression will notice the gap between what their intentions are and what the consequence is and will criticise themselves believing that the fault is in them. Their evaluation can prompt them to try harder through responding in the same way. A better evaluation and response is to try something different. .

STAIRCASE shows us the relationships between each of these key steps in CBT whilst opening up the possibility through situation evaluation of doing something different.